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SAN JOAQUIN COUNTY �- Is 0 (0 J <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR06Z 5 A <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0025635 <br /> Date Printed 11/5/202 <br /> <br /> <br /> <br /> <br /> OWNER : ACOSTA,ANA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0342304---Date of Invoice: 10/29/2020 11111 hill 111 111 11111 11111 11111 1111�11111 11111 AE 1111 EI IM11 1111111 IN <br /> 10/29/2020 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 155.00 <br /> Total for this Invoice $ 155.00 <br /> Payment Due Date 12/5/ <br /> TOTAL DUE this Billing Period $ 155.00 <br /> lcnwy.� <br /> Please make Checks PAYABLE to: 'EHD' <br /> Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />